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o&g Flashcards

(45 cards)

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1
Q

How long does Nexplanon progesterone contraceptive implant last for?

A

3 years

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2
Q

What is the timing of use of the drugs in pregnancy:

(a) trimethoprim
(b) nitrofurantoin

A

(a) AVOID trimethoprim in early pregnancy

(b) AVOID nitrofurantoin in late pregnancy

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3
Q

When is trimethoprim teratogenic in pregnancy

A

First trimester

- avoid during early pregnancy

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4
Q

When should nitrofurantoin be avoided in pregnancy

A

Near term (late pregnancy)

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5
Q

If trimethoprim and nitrofurantoin cannot be used in pregnancy, what can treat the UTI

A

cefalexin

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6
Q

Aromatase inhibitors (e.g. anastrozole) may cause what major side effect

A

osteoporosis

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7
Q

Selective oestrogen receptor modulators (SERMs) e.g. tamoxifen increase the risk of what cancer

A

Endometrial cancer

  • also increases risk of VTE, vaginal bleeding, amenorrhoea
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8
Q

all pregnant and breastfeeding women should take a daily supplement of what vitamin

A

Vitamin D

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9
Q

Women trying to conceive through to 12 weeks gestation should take what dose of folic acid

A

400mcg

5mg if epilepsy, neural tube defects, or diabetes

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10
Q

The symphysis-fundal height (SFH) is measured from the …. to the … in centimetres

It should match the gestational age in weeks to within 2 cm after 20 weeks, e.g. if 24 weeks then the a normal SFH = 22 to 26 cm

A

From the top of the pubic bone to the top of the uterus

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11
Q

The symphysis-fundal height (SFH) is from the top of the pubic bone to the top of the uterus in centimetres.

After how long should the SFH match the number of weeks?

A

After 20 weeks gestational age

The SFH should then match GA in weeks plus/minus 2cm, e.g. at 20 weeks = 18-22cm

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12
Q

first line medication for hypertension in pregnancy

A

labetalol

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13
Q

women who are at high risk of developing pre-eclampsia should take what medicine from 12 weeks until baby is born

A

aspirin 75mg OD

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14
Q

Combined oral contraceptive pill increases the risk of which 2 cancers and decreases the risk of which 2 cancers

A
  1. Increases the risk of breast and cervical cancer

2. Decreases the risk of ovarian and endometrial cancer

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15
Q

What is the treatment for group B streptococcus (GBS) found in vaginal swabs and urine during pregnancy?

A

Intrapartum IV benzylpenicillin

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16
Q

Women who have had a previous baby infected with GBS are offered what in future pregnancies

A

Intrapartum IV benzylpenicillin in future pregnancies

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17
Q

Which HPV are most commonly associated with cervical cancer

A

16, 18, 33

6 and 11 develop genital warts

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18
Q

tamoxifen can be used in oestrogen receptor positive, HER negative breast cancers in pre and peri-menopausal women. what is used if the woman is post-menopausal?

A

Anastrozole

for oestrogen receptor positive breast cancer in POST menopausal women

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19
Q

what treatment is used for HER positive, oestrogen receptor negative breast cancer?

Study These Flashcards
A

Trastuzumab (herceptin)

20
Q

8 absolute contraindications (UKMEC4) to COCP

Study These Flashcards
A
  1. > 35 years and >15cigs/day
  2. Migraine with aura
  3. History of VTE/genes
  4. History of stroke/IHD
  5. Breast feeding <6 weeks post-partum; or 21 days if not breastfeeding
  6. Uncontrolled HTN
  7. Breast cancer
  8. Major surgery
21
Q

When is the COCP stopped before major surgery, and restarted after

Study These Flashcards
A

Stopped 4 weeks before surgery

Restarted 2 weeks after

22
Q
  • vaginal discharge - offensive, green
  • vulvovaginitis
  • strawberry cervix
  • pH >4.5
  • can cause urethritis in men

What is the pathogen

Study These Flashcards
A

Trichomonas vaginalis

highly motile flagellated parasite STI. Micro shows motile trophozoites.

23
Q

What is the treatment for trichomonas vaginalis STI

Study These Flashcards
A

Oral metronidazole

24
Q

What is the pH in bacterial vaginosis and trichomonas

25
What daily supplements does the NHS currently advise all women take during pregnancy (in the absence of additional risk factors)?
folic acid 400mcg for the first 12 weeks, and vitamin D 10mcg throughout pregnancy
26
Contraceptives - time until effective (if not on first day of period): 1. Copper IUD 2. POP 3. COCP, implants, injection, Mirena IUS
1. IUD - immediately 2. POP - 2 days 3. COCP, implants, IUS - 7 days
27
treatment for vaginal candidiasis
clotrimazole cream/pessary if they are pregnant. Thrush cannot be treated with oral fluclonazole if they are pregnant.
28
Routine recall for cervical smear if recent smear was negative for (a) ages 25-49 (b) ages 50- 65
(a) Every 3 years | (b) Every 5 years
29
2 cervical smears that are inadequate samples 3 months apart requires..
colposcopy
30
women who are at high risk of developing pre-eclampsia should take 75mg aspirin OD from 12 weeks until baby is born. what are the 4 high risk groups?
1. previous pregnancy induced HTN 2. Autoimmune disorders e.g. SLE or antiphospholipid disorder 3. Diabetes 4. Chronic kidney disease
31
When do you need to refer painful periods (dysmenorrhoea) to gynae
Secondary dysmenorrhoea i.e. develops after many years after menarche to look for cause
32
Secondary dysmenorrhoea typically develops many years after the menarche and is the result of an underlying pathology. What are 4 causes
1. endometriosis 2. PID 3. adenomyosis 4. fibroids
33
what breast cancer drug increases the risk of endometrial cancer
tamoxifen
34
what is the classic symptom of endometrial cancer
post menopausal bleeding
35
Many ovulations will increase the risk of ovarian cancer as it increases oestrogen levels. Therefore what 3 risk factors will increase ovulations
1. Early menarche 2. Late menopause 3. No children n. b. these are same for endometrial cancer. also BRCA1/BRCA2
36
Pregnant women with gestational DM should be advised to maintain their blood glucose below the following target levels:
fasting: 5.3mmol/L AND 1 hour postprandial: 7.8 mmol/L or 2 hours postprandial: 6.4 mmol/L
37
combined HRT is used in patients with a uterus (no history of hysterectomy) because systemic oestrogen only HRT increases risk of...
endometrial cancer | also ovarian cancer risk increases with number of ovulations
38
perimenopausal (<12 months since last period) HRT treatment
combined cyclical HRT | combined continuous HRT is used in women >12 months since last period, and with uterus
39
menopause is defined as what time frame after last menstrual period
12 months
40
If the contraceptive patch change is delayed greater than 48 hours, what should be done?
Change patch immediately | Barrier method needs to be used for 7 days
41
Combined test for chromosomal disorders is is done between 11-13+6 weeks. The triple/quad test is done 15-20 weeks. What results in Down's syndrome would be shown?
- Thickened nuchal transulency - High serum b-hCG - Low PAPP-A - Low AFP - Low oestriol
42
It is advised that pregnant women taking phenytoin are given what to prevent clotting disorders in the newborn
vitamin K
43
urinary incontinence which occurs when laughing/coughing is called stress incontinence. Initial investigations are bladder diary for min 3 days, vaginal examination, Kegel exercises, urine dip MC&S, urodynamic studies what is the treatment for stress incontinence?
1. pelvic floor muscle training 2. surgery - retropubic mid urethral tape procedures 3. if do not want surgery, duloxetine
44
what is the treatment for overactive bladder/urge incontinence (i.e. detrusor overactivity)
1. bladder retraining for at least 6 weeks - to increase interval between weeing 2. medication - antimuscarinics e.g. oxybutynin (IR), tolterodine (IR) or once daily darifenacin 3. If old lady and frail and unable to tolerate antimuscarinics, try mirabegron (b3 agonist)
45
Hormone replacement therapy for menopause is contraindicated in what 4 criteria
1. Current/past breast cancer 2. Any oestrogen dependent cancer 3. Undiagnosed vaginal bleeding 4. Untreated endometrial hyperplasia

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